The Effect of Training on Knowledge and Skill of Early Detection of High Risk Pregnancy in Community Health Workers in Semarang, Central Java

Background: The maternal mortality ratio (MMR) in Indonesia is still high with an estimated 305 maternal deaths per 100,000 live births. Community health workers (CHWs) play a vital role in facilitating the continuum of care by acting as the bridge between the community and the health facility. However, CHWs are often not well-trained and many do not have the instruments needed to early detect high risk pregnancy. This study aimed to evaluate the effectiveness of training in improving knowledge and skill of CHWs in early detection of high risk pregnancy. Subjects and Method: This was a quasi-experimental study with one group pre and post test design. The study was conducted in Bandarharjo, Semarang, Central Java, from July to August 2017. A sample of 39 community health workers (CHWs) was selected for this study. The CHWs received training on early detection of high-risk pregnancy. The dependent variables were knowledge and skill in the early detection of high risk pregnancy. The independent variable was training. The data were collected by questionnaire and analyzed by Wilcoxon test. Results: Knowledge after training (mean= 81.73, SD= 15.10) was higher than before training (mean= 76.28; SD= 13.58) with p= 0.006. Skill after training (mean= 79.13, SD= 9.41) was higher before training (mean= 58.84; SD= 10.08) with p<0.001. Conclusion: Training is effective in improving knowledge and skill in the early detection of high risk pregnancy of the community health workers. Keywords: training, early detection, high risk pregnancy, knowledge, skill, community health worke

Association between Adherence to Treatment Management and The Quality of Life of The Elderly with Diabetes Mellitus

Background: Diabetes melitus (DM) is a worldwide public health problem and the fourth largest contributor of disease burden in Indonesia. Diabetes mellitus and adherence to treatment management may affect the quality of life of the affected elderly. This study aimed to estimate the associations of adherence to exercise, diet, and treatment, respectively, with the quality of life of the elderly with diabetes mellitus. Subjects and Method: A cross-sectional study was carried out at Puskesmas (Community Health Center) Rowosari, Semarang. The study site is an Inter professional Education (IPE) field lab operated by Faculty of Medicine, Universitas Diponegoro. Target population was the elderly with diabetes mellitus diagnosis. A random sample of 62 older patients with diabetes mellitus visiting Puskesmas Rowosari was selected for this study. The dependent variable was quality of life. The independent variables were adherence to exercise, diet, and treatment. Dietary pattern was measured by 3 day food recall. Quality of life was measured by Short Form-36. The other data were collected by questionnaire. The data were analyzed by Chi Square with Prevalence Ratio (PR) as the measure of association. Results: Bivariate analysis showed that quality of life improved with adherence to exercise (PR=8.67; 95%CI=2.09 to 35.89; p=0.001), adherence to diet (PR=6.39; 95%CI=1.32 to 30.92; p=0.012) and adherence to treatment (PR= 28.75; 95%CI=5.85 to 141.33; p<0.001), respectively, among the elderly with diabetes mellitus. Conclusion: Adherence to exercise, diet, and treatment, improves the quality of life of the elderly with diabetes mellitus. Keywords: diabetes mellitus, quality of life, treatment management, elderl

Health Behavior Associated with Quality of Life among Elderly with Hypertension

Background: The quality of life of elderly people has become increasingly important with the demographic shift to greying population. Quality of life is defined by personal feelings, details, outlook, and day to day experiences, which include how happy and positive one feels, how comfortable and secure, how productive and desired, how healthy and free an individual considers themselves, etc. This study aimed to determine health behavior associated with quality of life among elderly with hypertension. Subjects and Method: This was a cross sectional study conducted at Puskesmas (community health center) Rowosari, Semarang, Central Java. A sample of 62 elderly with hypertension was selected for this study by simple random sampling. The dependent variable was quality of life. The independent variables were adherence to treatment, physical exercise, diet, and smoking. Quality of life was measured by Short Form-36. Dietary pattern was measured by food recall. The other data were collected by questionnaire. The data were analyzed by chi square with prevalence ratio (PR) as the measure of association. Results: Adherence to treatment (PR= 10.27; CI 95%= 2.85 to 36.94; p<0.001), physical exercise (PR= 12.00; CI 95%= 2.26 to 63.86; p= 0.001), good diet (PR= 1.80; CI 95%= 1.40 to 2.34; p= 0.001), and smoking abstinence (PR= 3.36; CI 95%= 1.04 to 10.90; p= 0.038) were associated with better quality of life in elderly with hypertension. Conclusion: Adherence to treatment, physical exercise, good diet, and smoking abstinence are associated with good quality of life in elderly with hypertension

Associations of Healthy Behavior and Environment with Acute Respiratory Infection in Jepara, Central Java

Background: According to earlier studies, except during the neonatal period, Acute Respiratory Infections (ARIs) are the most common causes of both illness and mortality in children under five, who average three to six episodes of ARIs annually regardless of where they live or what their economic situation is. This study aimed to determine the associations of healthy behavior and environment with acute respiratory infectionin Jepara, Central Java. Subjects and Method: A cross-sectional study was conducted in Mororejo village, Mororejo, Jepara, Central Java, from January to February 2018. A sample of 210 families were selected for this study. The dependent variable was ARIs. The independent variables were health behavior and environmental factors. The data were collected by questionnaire. Data on ARIs were taken from medical record. Crude (bivariate) analysis was carried out to show association with prevalence ratio (PR) used as a measure of association and chi square to show statistical significance. Results: Incidence of ARIs was associated with smoking (PR= 1.44; CI= 1.10 to 1.88; p= 0.014), poor ventilation (PR= 1.78; CI= 1.12 to 2.83; p= 0.015), and crowded dwelling (PR= 3.61; CI= 1.37 to 9.50; p= 0.009). The associations of ARIs with washing hand, garbage disposal, bin ownership, floor cleaning, room light, and poultry ownership, were statistically non-significant. Conclusion: Incidence of ARI is associated with smoking, poor ventilation, and crowded dwelling. Keywords: acute respiratory infections, health behavior, environmen